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February 8, 1908


JAMA. 1908;L(6):422-425. doi:10.1001/jama.1908.25310320010001b

Two conclusions have impressed themselves on me regarding gastric ulcer: 1, Heretofore the condition has not been diagnosed early enough; 2, it has not received sufficiently rigorous treatment after the diagnosis has been made.

NEED OF EARLY DIAGNOSIS.  Early diagnosis is of immense value as an aid to cure, certainly as much so as in gastric cancer, possibly as much so as in pulmonary tuberculosis. It has been too much the custom in the past to consider no case gastric ulcer unless certain definite evidence was present, such as vomiting of blood, blood in the stools, violent attacks of gastralgia and lancinating pain through the abdomen from epigastrium to back. These signs are classical and are usually accepted as convincing, hut diagnosis ought to be made and treatment instituted before this stage has been reached.My own conviction is that many cases of chronic dyspepsia, characterized for weeks or months

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